• Michaela L James, Danielle Christian, Samantha C Scott, Charlotte E Todd, Gareth Stratton, Joanne Demmler, Sarah McCoubrey, Julian P J Halcox, Suzanne Audrey, Elizabeth A Ellins, and Sinead T Brophy.
• Swansea University Medical School, Swansea University, Swansea, United Kingdom. Electronic address: m.l.james@swansea.ac.uk.
• Am J Prev Med. 2020 Feb 1; 58 (2): 232243232-243.

IntroductionPhysical activity declines in adolescence, especially among those in deprived areas. Research suggests this may result from accessibility barriers (e.g., cost and locality). The Active Children Through Individual Vouchers Evaluation RCT aimed to improve the fitness and heart health of teenagers in Wales with the help of teenagers who co-produced the study.Study DesignThis study was a mixed-method RCT.Setting/ParticipantsBefore data collection, which took place at baseline, 6 months, and 12 months for both arms, 7 schools were randomized by an external statistician (4 intervention schools, n=524; 3 control schools, n=385).InterventionThe Active Children Through Individual Vouchers Evaluation intervention included provision of activity vouchers (£20 per month), a peer mentoring scheme, and support worker engagement for 12 months between January and December 2017. Data analysis occurred February-April 2018.Main Outcome MeasuresData included measures of cardiovascular fitness, cardiovascular health (blood pressure and pulse wave analysis), motivation, and focus groups.ResultsThe intervention showed a trend to improve the distance ran (primary outcome) and was significant in improving the likelihood of intervention teenagers being fit (OR=1.21, 95% CI=1.07, 1.38, p=0.002). There was a reduction in teenagers classified as having high blood pressure (secondary outcome) in the intervention group (baseline, 5.3% [28/524]; 12 months, 2.7% [14/524]). Data on where teenagers used vouchers and evidence from focus groups showed that teenagers wanted to access more unstructured, informal, and social activities in their local areas.ConclusionsActive Children Through Individual Vouchers Evaluation identified methods that may have a positive impact on cardiovascular fitness, cardiovascular health, and perspectives of activity. Consulting with teenagers, empowering them, and providing more local opportunities for them to take part in activities that are fun, unstructured, and social could positively impact teenage physical activity.Trial RegistrationISRCTN, ISRCTN75594310.Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.

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